Bottom Line:
Patients' scores were compared to the PS assessment of them made by their oncologists.This study showed that, with few exceptions, patients and oncologists assessed PS scores similarly.Although oncologists should continue to score PS objectively, it may benefit their clinical practice to involve their patients in these assessments.

ABSTRACTOncologists traditionally assess their patients' ECOG performance status (PS), and few studies have evaluated the accuracy of these assessments. In this study, 101 patients attending a rapid access clinic at Papworth Hospital with a diagnosis of lung cancer were asked to assess their own ECOG PS score on a scale between 0 and 4. Patients' scores were compared to the PS assessment of them made by their oncologists. Of 98 patients with primary non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC), weighted kappa statistics showed PS score agreement between patient and oncologist of 0.45. Both patient- and oncologist-assessed scores reflected survival duration (in NSCLC and SCLC) as well as disease stage (in NSCLC), with oncologist-assessed scores being only marginally more predictive of survival. There was no sex difference in patient assessment of PS scores, but oncologists scored female patients more pessimistically than males. This study showed that, with few exceptions, patients and oncologists assessed PS scores similarly. Although oncologists should continue to score PS objectively, it may benefit their clinical practice to involve their patients in these assessments.

fig5: Overall survival of 170 (nonstudy) patients with NSCLC enrolled in the two-stop clinic in 1998 compared with survival of 81 (study) patients with NSCLC. There was no statistical difference in survival between them. P=0.83.

Mentions:
Also, we compared the survival of patients with NSCLC in this study to that of 170 similar patients seen in the two-stop clinic in 1998. This was to show that patients in our study were typical of those seen in the two-stop clinic, and were managed according to usual clinical practice. In the 1998 group, 1-year survival was 35% (28%, 42%). There was no significant difference (P=0.77) in overall survival, adjusted for stage, between the 1998 patients and those in our study (Figure 5Figure 5

fig5: Overall survival of 170 (nonstudy) patients with NSCLC enrolled in the two-stop clinic in 1998 compared with survival of 81 (study) patients with NSCLC. There was no statistical difference in survival between them. P=0.83.

Mentions:
Also, we compared the survival of patients with NSCLC in this study to that of 170 similar patients seen in the two-stop clinic in 1998. This was to show that patients in our study were typical of those seen in the two-stop clinic, and were managed according to usual clinical practice. In the 1998 group, 1-year survival was 35% (28%, 42%). There was no significant difference (P=0.77) in overall survival, adjusted for stage, between the 1998 patients and those in our study (Figure 5Figure 5

Bottom Line:
Patients' scores were compared to the PS assessment of them made by their oncologists.This study showed that, with few exceptions, patients and oncologists assessed PS scores similarly.Although oncologists should continue to score PS objectively, it may benefit their clinical practice to involve their patients in these assessments.

ABSTRACTOncologists traditionally assess their patients' ECOG performance status (PS), and few studies have evaluated the accuracy of these assessments. In this study, 101 patients attending a rapid access clinic at Papworth Hospital with a diagnosis of lung cancer were asked to assess their own ECOG PS score on a scale between 0 and 4. Patients' scores were compared to the PS assessment of them made by their oncologists. Of 98 patients with primary non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC), weighted kappa statistics showed PS score agreement between patient and oncologist of 0.45. Both patient- and oncologist-assessed scores reflected survival duration (in NSCLC and SCLC) as well as disease stage (in NSCLC), with oncologist-assessed scores being only marginally more predictive of survival. There was no sex difference in patient assessment of PS scores, but oncologists scored female patients more pessimistically than males. This study showed that, with few exceptions, patients and oncologists assessed PS scores similarly. Although oncologists should continue to score PS objectively, it may benefit their clinical practice to involve their patients in these assessments.